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Chronic Inflammatory Skin Disease: Hidradenitis Suppurativa

By HERWriter
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Hidradenitis suppurativa is a chronic inflammatory skin disease that appears as a combination of blackheads, sores, small-reddened tender bumps or larger abscesses that may open and drain pus-like fluid.

It commonly affects apocrine sweat-bearing areas of the body such as in the armpit, groin or under the breasts. Scarring is common with hidradenitis suppurativa, and sinus tracts can develop under the skin in between abscesses, making treatment and healing difficult. Hidradenitis suppurativa is considered to be a severe form of acne.

Causes of Hidradenitis Suppurativa

It is unclear as to what actually causes hidradenitis suppurativa, but there seems to be disturbance around the openings of the hair follicles and sebaceous glands, which become blocked with dead skin cells and secretions of the sweat (apocrine) glands. Bacteria are then trapped and grow, causing infections in skin.

Various factors are thought to contribute to the development of hidradenitis suppurativa. Hidradenitis suppurativa seems to occur in families, so genetics are thought to play a role. Hormone or endocrine factors may stimulate it, and hidradenitis suppurativa occurs more often in cigarette smokers.

According to Dermnetnz.org, women are affected three times more often then men, and the most common age of occurrence is between puberty and the age of 40.


After a doctor examines you, he may order blood tests or send off any drainage from skin lesions to be cultured for bacteria.

Mild cases of hidradenitis suppurativa may be treated with warm compresses and antibacterial soap washings.

Moderate cases may additionally require the use of medications. Antibiotics, topical or oral, may be needed for ongoing treatment to prevent worsening of the condition or further outbreaks. Oral retinoids can help reduce plugging of hair follicles.

NSAIDs may help with pain and swelling. Corticosteroids may be used, which are stronger medications that reduce inflammation. Birth control pills or other hormone suppressing medications such as spironalactone may be tried.

Severe cases may need surgery to open tunneled tracts and drain pocketed areas full of pus discharge. Surgical removal of involved skin areas may require more extensive repair afterwards, with use of a skin flap to cover the opened area, or a skin graft from another part of the body.

Unfortunately, surgery does not prevent a recurrence of hidradenitis suppurativa.

General Prevention

Though hidradenitis suppurativa cannot be prevented, various life style changes may reduce discomfort and help in healing.

- Use warm compresses when you feel inflammation is starting in an area.

- Wash affected areas with antibacterial soaps and apply topical antibiotics such as Neosporin if your doctor recommends it.

- Wear loose clothing so the skin is able to have better air circulation.

- Avoid shaving, which can irritate the skin.

-Stop smoking and try and lose weight if needed, so that skin surfaces do not rub against one another, trapping sweat.

According to Mayoclinic.com, “zinc gluconate supplements (zinc salts) taken daily may help reduce inflammation and prevent new outbreaks”.

Hidradenitis suppurativa can be an especially distressing condition. People feel embarrassed or anxious due to foul odor of the draining lesions and so do not seek medical care. It is important for these people to reach out for help, despite feeling self-conscious.

Support for those who suffer from hidradenitis suppurativa here in the United States can be found at the Hidradenitis Suppurativa Foundation, Inc. http://www.hs-foundation.org/

They have a section to help find a doctor and have information about current research and treatments. HS-USA, at http://www.hs-usa.org/index.htm is also working on developing an online forum, and they have a 24 hr support line.

Other support groups from other countries are listed at the end of the #2 source below.


1. Hidradenitis suppurativa. Mayoclinc.com. Web. April 14, 2012.

2. Hidradenitis suppurativa. DermNet NZ. Web. April 14, 2012.

Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles

Edited by Jody Smith

Add a Comment17 Comments

EmpowHER Guest

Hidradenitis suppurativa, painful, pea-sized lumps are symptoms of hidradenitis suppurativa. Information about Hidradenitis Suppurativa Natural Treatment including its cause and natural treatment.

April 6, 2017 - 3:20am
EmpowHER Guest

This is some effective ways yes, i have tried some of this, but this little blog tought me great ways to remove my HS, and thankfully after long battle, it is gone now. this is the blog
i hope this info helps someone.

December 1, 2014 - 1:52am
EmpowHER Guest

Free treatment for those who qualify for this research project for the treatment of Lichen Sclerosus. Go to this website: www.LichenSclerosusTreatment.com

August 25, 2014 - 1:01am

Thank you Rick for your comment and links to your FB group. You are obviously very knowledgeable and offer good leadership for the HS community 

I have been contacted by someone who is the administrator of one of the other FB groups to gather info to present a follow up article to discuss how HS has affected their lives, which I intend to write.

I write on many subjects and the scope of this article was to write a general overview about HS, which despite my missing of the latest info did bring awareness of this difficult condition to those who had never heard of it.

As in many conditions there is always more recent data that is not on mainstream sources, which clearly HS has that I was unaware of in writing this article.

What I do suggest is you all contact the Mayoclinc.com directly since certainly more people are reading about HS there than from my article. They write that HS is considered (note that means put in the category of type of care--not equal) a form of severe of acne and they list recommended treatment guidelines. Their article is dated 2010.

I apologize for not bringing out the amount of pain the condition has, which clearly is a large part of difficulty of having HS.

As a nurse, I wanted to make sure to include links to support groups, which are vital regardless of what chronic condition a person has, to allow them to find others afflicted or knowledeable medical care that may help them. I made a point of including how your organization, HSA has 24 hr hot line as well.   

Thanks again for taking time to report the latest info.  It is clear that HS, as with many chronic incurable illnesses, does not have a straightforward cause or treatment. 

Hopefully my next article will give more of a face to the lives of those who have HS. 


April 17, 2012 - 5:36am
EmpowHER Guest

Michele, Thank you for the article and the time you spent on the article. Your resource information is a bit dated. A Geneticist has identified the particular level in the Genome and has identified the the specific marker for HS. Maybe I missed it, but little is mentioned about the pain associated with the disease. I have lived with it for more than 40 years, the pain levels HS patients live with is severe. Antibiotics are almost always ineffective. Research has consistently confirmed that HS cultures absent secondary infection, will culture negative. While strong evidence supports that Androgen and Hormone imbalances will exacerbate the condition, few doctors ever run the studies to correct those imbalances.
There are a number of "Support Groups" that are online, however, caution should be used. There are only two that I know of that are not supported by commercial backers. You mentioned HSF, I am personally familiar with the organization and the do good work. The other is HS-USA. (www.hs-usa.webs.com) HS-USA was one of the first HS non profit groups out there that has supported research and treatment options. The site has a ton of information available to the Medical Community as well as for Patients. There is a forum available to post questions and get responses. There is also a chat room available to members and a 24 hour emergency support line.
I extend an open invitation for you to join us at any time. We also work closely with a Facebook group at https://www.facebook.com/groups/HSKnowledgeiskey/

Thanks again for your time and work
Rick H.
HS-USA forums Moderator and Site Manager

April 16, 2012 - 9:24pm
EmpowHER Guest

This article is so far off. Unfortunately, it is obvious that the writer didn't do her homework. HS is NOT a form of acne. HS is a disease. Acne is a condition. For truths about HS, read this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3084959/

April 16, 2012 - 8:14pm
EmpowHER Guest

If you wish to speak with people who have HS please go to the public facebook group which exists to promote public awareness about the disease and to teach.


Also if you would like my story and to speak with me personally my blog with extremely graphic images is here tjkorri.blogspot.com
My email is [email protected] oh and my name is Teri. I will send you an email with more information and details as to ongoing projects to spread awareness and correct information about HS. thanks for your willingness to learn more.

April 16, 2012 - 5:47pm
EmpowHER Guest

We are aggravated at the lack of research and true response to this disease. There should be more research for the cause of this disease, and even more research into finding a cure, or at least longer lasting help. Surgery scares me because I see where people have it come back in the same spot, or worse in other parts of their body. Also, I have seen the pictures of surgeries, and heard about MRSA and other skin diseases and disorders that come after surgery. There are so many risks that come with the temporary answers. We just ask that the truth be told, and that people are shown the truth of having a disease that is like cancer, except you don't you don't die from this, but for a lot of us, the suffering makes you feel like you are dying.

April 16, 2012 - 4:31pm

Thank your for the link.  You obviously have knowledge that one who has this particular condition must struggle with. I can see that despite the limitations of my article, it has allowed those of you to come out and express your frustration with the mainstream treatments available.

Again, I invite anyone to email me if they would like me to tell their story in a follow up article.  You can send me a private message by clicking my name to get to my page. 






April 16, 2012 - 3:20pm

To refer to HS as a severe form of acne is to throw water on the issue itself. HS is hereditary, as many people I know who have it have a family member or had a family member who has it. I quit smoking almost a year ago, so I'm sure that smoking didn't cause it. I am not overweight. I started at stage 2, and went straight into stage 3. You also forgot to mention exactly how debilitating this disease can be, not just physically, but mentally. Birth control almost killed me, as I have a clotting disorder. I don't have any of the major diseases that are associated with the development of HS. My abcesses don't drain. They stay under the skin. Also, it has been found that this disease affects more than just the groin, under arms, and under the breasts.

April 16, 2012 - 2:31pm
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